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Australian Hotels Association
X. Yu, D. O’Connell, R. Gibberd, M. Abrahamowicz, B. Armstrong (2008)
Misclassification of colorectal cancer stage and area variation in survivalInternational Journal of Cancer, 122
Australasian Legal Information Institute
X. Yu, D. O’Connell, R. Gibberd, A. Coates, B. Armstrong (2006)
Trends in survival and excess risk of death after diagnosis of cancerin 1980–1996 in New South Wales, AustraliaInternational Journal of Cancer, 119
D. Levy, F. Chaloupka, J. Gitchell (2004)
The effects of tobacco control policies on smoking rates: a tobacco control scorecard.Journal of public health management and practice : JPHMP, 10 4
H. Barraclough, S. Morrell, Maria Arcorace, H. McElroy, D. Baker (2008)
Degree‐of‐spread artefact in the New South Wales Central Cancer RegistryAustralian and New Zealand Journal of Public Health, 32
R. Walsh, C. Paul, F. Tzelepis, E. Stojanovski, A. Tang (2008)
Is government action out‐of‐step with public opinion on tobacco control? Results of a New South Wales population surveyAustralian and New Zealand Journal of Public Health, 32
(2008)
Rees put brake on smoke bans
The Impacts of Indoor Smoking Bans
We note the important paper by Barraclough et al. describing an artefactual increase in cancer cases recorded with unknown degree‐of‐spread (stage) in the NSW Central Cancer Registry for the period 1993 to 1998 and its potential impact on analyses that require stage adjustment. We would like to provide some additional information on the accuracy of the Cancer Registry's stage information and its potential impact on stage adjustment. In a study comparing colorectal cancer stage recorded in the NSW Central Cancer Registry, with that from a survey of treating surgeons, we found that the overall agreement between the registry stage and survey stage was 69.5%. The registry stage appeared biased towards over‐reporting of localised disease and spread to regional lymph nodes and under‐reporting of spread to adjacent tissues and distant metastases. As the patients included in the comparison were diagnosed between 1 February 2000 and 31 December 2000, the result does not relate to the artefact period but indicates important, possibly ongoing, stage misclassification. This had an important impact on estimates of spatial variation in stage‐specific colorectal cancer survival. The probable stage misclassification that we have described and the staging artefact that Barraclough et al. have described could have had an impact on our examination of trends in stage adjusted survival from cancer in NSW. We acknowledged this at the time: “These considerations notwithstanding, there remains justifiable concern about the impact of the increase in the proportion of unknown stage cancers on our adjustment for stage of cancer and especially the possibility that the distribution of stages within this unknown stage group may also have changed with time, a possibility we cannot rule out.” This acknowledgement notwithstanding, we now consider it unlikely that the staging artefact had an important effect on the trends in survival we reported. An examination of our data for evidence of stage migration (a well‐recognised artefact in trends in cancer stage) showed that most of the observed increases in survival were present in all stage categories and that for most cancers overall survival, when unadjusted for spread of cancer, generally fell in parallel with that in the specific stage categories. In addition to ruling out important stage migration, this pattern also excludes an important effect of the reported staging artefact.
Australian and New Zealand Journal of Public Health – Wiley
Published: Feb 1, 2009
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